Background Tumor markers can be diagnostically suggestive and are sometimes even related to prognostic prediction certain diseases. Multiple studies have shown the effectiveness in the prediction of prostate cancer (PCa) by the use of C-reactive protein (CRP). This meta-analysis was conducted to facilitate a conclusion regarding the values of CRP in the prediction of survival rate in patients with PCa. Methods Manuscripts were searched, identified, and collected from different databases; quality evaluation was performed according to the different search strategies involved. Information including the comparison between overall survival (OS) and cancer-specific survival (CSS) rate were retained from different studies in patients with evaluated or lowered CRP levels. Progression-free survival (PFS) was also recorded in relation to the log of CRP. Level of relevance was assessed using hazard ratio (HR) and 95% confidence interval (CI). Heterogenicity testing was performed by using Cochran’s Q test and Higgins I 2 statistics. When P value <0.05, the outcome was considered statistically significant. Results A total 12 of manuscripts were included and evaluated from the 1,523 initially identified studies. The results of OS and PFS were 1.57 (95% CI: 1.34 to 1.85) and 1.50 (95% CI: 1.25 to 1.81), respectively. For CSS, the combined HR and 95% CI was 1.92 (95% CI: 1.36 to 2.70), which revealed a significant correlation between increased level of CRP and CSS in PCa patients. Conclusions This meta-analysis revealed that CRP value could be one of the critical indicators to predict the survival rate of PCa patients.
Objective This meta-analysis aims to explore the association between angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism and susceptibility to prostate cancer (PCa). Methods We searched studies related to ACE I/D polymorphism and susceptibility to PCa through PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases from inception to June 1, 2022. Five gene models, including allelic, dominant, recessive, homozygote, and heterozygote models, were analyzed. The pooled odds ratio (OR) was calculated using Stata 15.0 software. Publication bias was judged by the funnel plot and Egger’s test, with the robustness of the findings verified by sensitivity analysis. Results Eight published articles (including ten studies) were identified. The pooled results showed that ACE I/D locus polymorphism was significantly correlated with the risk of PCa under all gene models except for the heterozygous model (D vs. I: OR= 1.58, 95% CI: 1.14–2.21; DD vs. DI+II: OR=1.68, 95% CI: 1.11–2.54; DD+DI vs. II: OR=1.76, 95% CI: 1.11–2.80; DI vs. II: OR= 1.44, 95% CI: 0.99–2.10; DD vs. II: OR= 2.12, 95% CI: 1.15–3.93). Subgroup analysis based on genotype frequencies in the control group meeting Hardy-Weinberg equilibrium showed statistically significant differences in all gene models. The funnel plot and Egger’s test indicated no publication bias. The sensitivity analysis verified the robustness of the conclusions obtained in this meta-analysis. Conclusion ACE I/D locus polymorphism correlates to PCa risk. Allele D, genotype DD+DI, and DD at the ACE I/D locus increase susceptibility to PCa and can therefore serve as a potential diagnostic and screening molecular marker for PCa patients.
Purpose: The feasibility and safety of the direct puncture tunnel method to establish the retroperitoneal cavity was assessed by CT and clinical experience. Materials and Methods: Ten patients who underwent retroperitoneoscopic procedure were scanned by CT in the lateral decubitus position. The distance between the lumbar fascia and psoas major muscle (L-P distance) on the puncture line was measured. The angle between the puncture line and the posterior colon margin (P-C angle) was also measured. In total, 292 patients who underwent retroperitoneoscopic procedure were used to establish the retroperitoneal cavity using the direct puncture tunnel method, and complications in these patients were evaluated. Results: The average L-P distance was 25.0 mm (left side) and 25.5 mm (right side) in the lateral decubitus position. The average P-C angle was 26.8°(left side) and 29.7°(right side). The retroperitoneal cavity was well established in all 292 patients, and no visceral or blood vessel injury occurred. Conclusions: CT scans in the lateral recumbent position indicate that there are no visceral and large blood vessels on the puncture path. The scans also provide a window for inserting the first trocar blindly into the retroperitoneum. A high success rate and low complication rate were observed clinically for the direct puncture tunnel method. We consider the direct puncture tunnel method to be a simple, effective, and safe way to establish the retroperitoneal cavity.
The bladder wall is constantly subjected to intravesical pressure during the filling and voiding cycles. An imbalance between matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) under elevated intravesical pressure contributes to pathological changes in the bladder. To investigate the changes in human urothelial cells (HUCs) under elevated intravesical pressure, this study analyzed the effect of β‐adrenoceptor signaling on the expression of MMPs and TIMPs in HUCs exposed to pathological hydrostatic pressure (HP) (70 cm H2O) for 6 hours. Quantitative polymerase chain reaction, Western blot analysis, and cell fluorescence staining were used to explore the effect of β‐adrenoceptor signaling on the expression of MMPs and TIMPs in HUCs after agonist and/or antagonist treatment. The expression levels of β2‐ and β3‐adrenoceptor, MMP1, and MMP2 were greatly downregulated, while the expression of TIMP1 was greatly upregulated. Formoterol and BRL 37344, which are agonists of β2‐ and β3‐adrenoceptor, respectively, significantly increased MMP1 and MMP2 expression under 70 cm H2O. As a classic downstream pathway of β2‐ and β3‐adrenoceptor, protein kinase A (PKA) signaling inhibited MMP1 and MMP2 expression by regulating cAMP response element binding protein (CREB) activity. MMP1 and MMP2 expression in HUCs under 70 cm H2O was modified by β2‐ and β3‐adrenoceptor via the PKA/CREB pathway. This outcome suggests that MMPs likely participate in the pathological effects of elevated intravesical pressure. The underlying mechanism of β2‐ and β3‐adrenoceptor in elevated intravesical pressure was also revealed; this mechanism constitutes a new potential therapeutic target for partial bladder outlet obstruction.
Background Cryptococcal meningitis (CM) is an inflammatory mycosis of the central nervous system caused by meninge infection or brain parenchyma with Cryptococcus species. It is associated with high morbidity and mortality, and patients with acquired immune deficiency syndrome are particularly susceptible. There have been increasing reports of CM in HIV-negative patients in China over the last few years. Case presentation A 31-year-old healthy Chinese male presented with fever and gradually developed headache, projectile vomiting, and other manifestations that were later confirmed as Cryptococcus gattii meningoencephalitis. However, multiple disease changes occurred during the course of treatment, and the regimen was accordingly modified after the diagnosis of post-infectious inflammatory response syndrome (PIIRS). The patient eventually recovered. Conclusion There has been a growing trend in the incidence of C. gattii meningoencephalitis in HIV-negative patients. It shows rapid onset and severe prognosis. This case report can provide a reference to treat PIIRS following CM in HIV-negative patients.
Objective. To investigate the association between the rs13347 polymorphism of the CD44 gene and the risk of kidney stone disease (KSD) in the Han population of northeast Sichuan, China, so as to provide a theoretical basis for the treatment of KSD. Methods. We used PCR-restriction fragment length polymorphism (RFLP) technique to perform genotyping at rs13347 locus of the CD44 gene in the KSD group and the gontrol group. SNP Hardy-Weinberg equilibrium (HWE) testing was used to confirm the balance of genetic inheritance. Multivariate logistic regression analysis was used for the assessment of rs13347 polymorphism and the risk of developing KSD and to compare the relationship between the polymorphism of rs13347 and clinical characteristics of patients with KSD. Results. Genotypic results of rs13347 locus of the CD44 gene in the two groups were consistent with the SNP-HWE test, indicating the genetic balance. At the same time, multivariate logistic regression analysis indicated that subjects with CT and TT genotypes at rs13347 in the CD44 gene were more likely to have KSD, and there was a higher prevalence rate in males. Furthermore, carrying allele T at rs13347 was also a risk factor for KSD. In addition, people carrying CT and TT genotypes at rs13347 also have a significantly increased risk of relapsing KSD. Conclusion. The rs13347 polymorphism of the CD44 gene may be associated with the risk of KSD in the Han population of northeast Sichuan in China, and the recurrence rate of KSD in the carriers of CT and TT genotypes is higher.
Percutaneous nephrolithotomy is the preferred treatment for large renal calculi; however, postoperative hemorrhage is a dangerous complication. The three main causes of hemorrhage after percutaneous nephrolithotomy are pseudoaneurysms, arteriovenous fistulas, and arterial lacerations. The preferred treatment for acute hemorrhage is superselective angioembolization. However, in a few cases, angiography reveals no abnormal findings pertaining to hemorrhage. We herein present a clinical case of a 48-year-old man who presented with multiple complex right renal calculi and was managed with percutaneous nephrolithotomy in the prone position. Massive hemorrhage occurred 6 days postoperatively, and renal angiography was immediately performed. However, while the bleeding was still occurring, no extravasation was observed on renal angiography. We performed retroperitoneal laparoscopic renorrhaphy, which successfully stopped the bleeding and consequently preserved the kidney. We suggest that retroperitoneal laparoscopic renorrhaphy can be effective in patients who have undergone failed renal arterial embolization or are reluctant to undergo renal arterial embolization.
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